NPIMap

Individual provider Active NPI

Roxanee E Pierre, MD

  • Family Medicine Physician
  • St Anthony, MN
National Provider Identifier
1225292964
Registry record updated Apr 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
51229 Issued in MN
Practice address
2714 Highway 88
St Anthony, MN 55418-3266
Phone
(612) 873-7201
Fax
(612) 873-1950
NPI assigned
Jul 11, 2008
Last updated
Apr 26, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 103655 MN
Family Medicine Physician 207Q00000X 51229 MN Primary

Addresses

Primary practice location

2714 Highway 88
St Anthony, MN 55418-3266

Mailing address

2714 Highway 88
St Anthony, MN 55418-3266
Phone (612) 873-7201

Other names 1

  • Roxanee E Charles Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20080926000044 MN Practitioner - Family PracticePractitioner - Emergency Medicine 9537236971 Reassigns benefits to 2 organizations
I20231129000225 WI Practitioner - Family Practice 9537236971 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mahnomen Health CenterGroup PAC ID 3375546112, 4 clinicians

Practice addresses (Care Compare)

414 W Jefferson Ave
Mahnomen, MN 56557-4912
Phone (218) 935-9401

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
103655MNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aspirus Stanley Hospital & Clinics, Inc. CurrentSince Dec 7, 2023 Accepting new patients
Aspirus Stanley Hospital & Clinics, Inc. Family Medicine CurrentSince Dec 7, 2023 Accepting new patients
Eden Pathways Current Accepting new patients
Welia Health Current Accepting new patients
Aspirus Stanley Hospital & Clinics, Inc CurrentSince Dec 7, 2023 Accepting new patients
Mahnomen Health Center CurrentSince Dec 19, 2024 Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

414 W Jefferson Ave
Mahnomen, MN 56557
Phone (218) 935-2511

301 Highway 65 S
Mora, MN 55051
Phone (320) 225-3317

1120 Pine St
Stanley, WI 54768
Phone (715) 644-5530

Interoperability endpoints

  • Direct secure messaging: rpierre185407@direct.centracare.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1215734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335398400000",
    "number": "1225292964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2714 HIGHWAY 88",
            "city": "ST ANTHONY",
            "state": "MN",
            "postal_code": "554183266",
            "telephone_number": "612-873-7201",
            "fax_number": "612-873-1950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2714 HIGHWAY 88",
            "city": "ST ANTHONY",
            "state": "MN",
            "postal_code": "554183266",
            "telephone_number": "612-873-7201",
            "fax_number": "612-873-1950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIERRE",
        "first_name": "ROXANEE",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-11",
        "last_updated": "2012-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "103655",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "51229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROXANEE",
            "last_name": "CHARLES",
            "middle_name": "E",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in St Anthony, MN

Sources for this page

Verify at the official NPI Registry.